Acute Care NP vs CNS...Looking for more info about Acute Care NP Degree/Roles

Advanced Practice Columnist / Guide · Jul 5, 2012

I would like to hear from the ACNP's out there! I am interested in the NP role in the critical care/emergency setting.
Do you have previous exp. as an ICU or ER nurse?
What is your current role? What are your primary responsibilities?
What is your role like in relation to the MDs and RNs you work with?
What is the difference btw. AC NP and CNS? My local state university has an AC CNS program -- hardly any info on the website. Is this role different from ACNP?
Any info would be much appreciated!!!
Thanks!

I am an Adult Acute Care NP who graduated from my program in the Midwest in December 2003. My background before starting grad school includes about 10 years total of bedside RN experience in Adult Medical Units/Telemetry, SICU, and ED. I didn't start out working in critical care right out of my ACNP program as I took an in-patient PM&R NP position initially and worked there for a year.

In 2004, I found my dream job which was to work with an intensivist service in a Cardiothoracic Surgery ICU. It was a busy unit with sick post-open heart and lung surgery patients as well as an active heart and lung transplant service. We were part of the provider team which consisted of the intensivist, a surgical critical care fellow, NP, and a PGY2 General Surgery resident. The surgeons worked closely with our team.

As providers, we managed patients including vents, vasoactive drips, attended to codes, placed central and arterial lines, placed chest tubes, and performed bronchoscopies. These were part of the institutional credentialing packet we went through when we got hired. The NP team all have various ICU backgrounds prior to becoming NP's. Not all the NP's are ACNP trained. The hospital itself employs over 200 NP's system wide in various roles.

The unit had a CNS. This person was trained years ago in a Master's degree program in Medical-Surgical Nursing. If I'm not mistaken she uses the ACNS-BC credential which means she is certified as an Adult Health CNS by ANCC. She acts as a resource to bedside nurses, coordinates the nursing staff's educational needs with her team of nurse educators (BSN-prepared nurses), and sits in institutional committees that write policies and procedures for the hospital.

I have since moved out of state on the West Coast. My role here is just slightly different. I still work for a hospital, albeit a true academic medical center affiliated with a medical, nursing, pharmacy, and dental school that is state funded. I am part of a group of 12 NP's who work with the hospital's interdisciplinary Division of Adult Critical Care Medicine.

In my current role, we round on different Adult ICU's - Med/Surg ICU, Neurosurgery/Neurovascular/Neurology ICU, and Cardiology/Cardiac Surgery/Vascular Surgery ICU. The responsibilities are the same as in my previous job. All 12 NP's are trained as ACNP's and majority are graduates of the university we're affiliated with.

We also have one CNS assigned to each ICU here. A few of our CNS's are well-published and active in AACN (Amer. Assoc. of Crit. Care Nurses) and one is a fellow of the American Academy of Nursing and the Society of Critical Care Medicine. A number have PhD's. Some carry the CCNS credential which is basically acquired through AACN. However, they have the same role as in my previous job.

Advanced Practice Columnist / Guide · Jul 5, 2012

My local state university has an AC CNS program -- hardly any info on the website. Is this role different from ACNP?

The program title alone tells me that graduates won't qualify to sit for either of the two ACNP certification exams so it is not the same as an ACNP program.

foreverLaur · Jul 5, 2012

The Adult-Gerontology Acute Care Nurse Practitioner (AGACNP) program trains graduates to practice as advance practice nurses with young adults, adults, and older adults who have acute/critical care needs. More specifically, graduates are prepared to care for patients with complex health problems including those with acute, critical, and chronic health conditions. Pharmacology, diagnostic reasoning and decision-making, therapeutic interventions, advanced assessment, consultation and referral skills are intrinsic components of their practice.

The Adult-Gerontology Clinical Nurse Specialist (AGCNS) is an advanced practice nurse who provides expert nursing care, implements evidence-based interventions and influences the delivery of care within the health care system. The course of study prepares a clinical nurse specialist to function autonomously and in collaboration with health care providers as a practitioner, educator, consultant, researcher and manager.

allnurses Guide · Jul 6, 2012

I just graduated in PA as a ACNP. My background is 15yrs of cardiothoracic critical care and transplant. I am certified as CCRN-CSC-CMC.

I haven't decided on job yet but the options are with critical care doing things as described above (managing ICUs overnight doing management, lines, etc)